Cost-effectiveness of the sequential application of tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia
| Autor: | Jerald P. Radich, David D. Stenehjem, Diana I. Brixner, M. Kluibenschaedl, Uwe Siebert, Ursula Rochau, Günther Gastl, Beate Jahn, Dominik Wolf, Stefan Schmidt, Annette Conrads-Frank, Gaby Sroczynski |
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| Rok vydání: | 2014 |
| Předmět: |
Oncology
Male Cancer Research medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis Antineoplastic Agents Pharmacology Decision Support Techniques hemic and lymphatic diseases Internal medicine Leukemia Myelogenous Chronic BCR-ABL Positive Antineoplastic Combined Chemotherapy Protocols Outcome Assessment Health Care medicine Humans Registries Protein Kinase Inhibitors business.industry Hematopoietic Stem Cell Transplantation Myeloid leukemia Imatinib Hematology Cost-effectiveness analysis Health Care Costs Markov Chains Dasatinib Nilotinib Austria Cohort Female Quality-Adjusted Life Years business Tyrosine kinase medicine.drug |
| Zdroj: | Leukemialymphoma. 56(8) |
| ISSN: | 1029-2403 |
| Popis: | Several tyrosine kinase inhibitors (TKIs) are approved for chronic myeloid leukemia (CML) therapy. We evaluated the long-term cost-effectiveness of seven sequential therapy regimens for CML in Austria. A cost-effectiveness analysis was performed using a state-transition Markov model. As model parameters, we used published trial data, clinical, epidemiological and economic data from the Austrian CML registry and national databases. We performed a cohort simulation over a life-long time-horizon from a societal perspective. Nilotinib without second-line TKI yielded an incremental cost-utility ratio of 121,400 €/quality-adjusted life year (QALY) compared to imatinib without second-line TKI after imatinib failure. Imatinib followed by nilotinib after failure resulted in 131,100 €/QALY compared to nilotinib without second-line TKI. Nilotinib followed by dasatinib yielded 152,400 €/QALY compared to imatinib followed by nilotinib after failure. Remaining strategies were dominated. The sequential application of TKIs is standard-of-care, and thus, our analysis points toward imatinib followed by nilotinib as the most cost-effective strategy. |
| Databáze: | OpenAIRE |
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